From: Reuters
Published May 30, 2008 10:02 AM

Death of spouse ups odds of nursing home care

By Megan Rauscher

NEW YORK (Reuters Health) - An older person's likelihood of entering a nursing home or other long-term care facility is particularly high immediately after the death of a spouse, new research indicates.

There could be various reasons for this, Elina Nihtila, of the department of sociology at the University of Helsinki, Finland, who led the research, told Reuters Health.

"It may be related to the loss of social and instrumental support, in the form of care and help with daily activities such as help in cooking, cleaning, and shopping formerly shared with the deceased spouse," Nihtila said.

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"Second, grief and spousal loss may cause various symptoms, such as depression and anxiety, loss of appetite, sleep disturbances, fatigue and loss of concentration that could increase the need for institutional care." She added. "Furthermore, grief may cause increased susceptibility to physical diseases."

The research team analyzed how the death of a spouse affects the likelihood of entering institutionalized care among nearly 141,000 Finnish adults aged 65 and older. All of them were living with a spouse at the beginning of the study and were followed for five years.

"The data were unique in that they covered a large number of persons bereaved during the follow-up and gave the dates of bereavement and of first admission into institutional care," Nihtila and colleagues explain in the American Journal of Public Health.

Results showed that the risk of entering long-term institutional care was higher among older adults who had lost their spouse than among those living with their spouse. "The excess risk of institutionalization was highest during the first month after the spouse's death -- more than three times higher among both men and women -- and decreased with time from bereavement, stabilizing at approximately 20% to 50% higher over 1 to 5 years," Nihtila noted.

The researcher thinks home help services "should be targeted to the bereaved immediately after a spouse's death to reduce the need for institutional care."

SOURCE: American Journal of Public Health, July 2008 (online May 29, 2008).

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